Analysis of Primary CNS Lymphoma and Its Overall Survival, Assessment of Response Rate, and Its Toxicity Profile (Grade III/IV Toxicity) with High-Dose Methotrexate-Based Chemotherapy in Tertiary Care Hospital
Year: 2026
Type: article
Abstract: Aims and Objectives: Primary Objective: Analysis of primary CNS lymphoma and its clinical feature and outcome of treatment at FMRI since January 2014. Secondary Objective: Assessment of response rate Overall survival Pattern of failure Grade V toxicity due to treatment Materials and Methods: Single center ambispective analysis of histopathologically proven patients of primary CNS lymphoma attending the Department of Medical oncology, FMRI. These patients were treated with chemotherapy from January 2013 to November 2025. Adverse events during chemotherapy were documented and graded using CTCAE v.5 (Common terminology criteria for adverse events). Results: Till now 40 patients enrolled since January 2013 to January 2023 who were registered at our institute and received high-dose methotrexate (HDMTX)-based chemotherapy with sufficient medical records were analyzed. The median age was 58 years (range, 22–82 years), and the ratio of male to female was 3:1. Multiple intracranial lesions were present in 47.5% of patients. The CR was 20 (50%), PR was 4 (10%), PD was 2 (5%), expired 14 (35%). The ORR = CR + PR (overall response rate) was 60%. Mortality rate 14 (35%). Overall survival 26 (65%). Significant grade IV toxicities were neutropenic sepsis 9 (22.5%), grade IV pancytopenia 2 (5%), SIADH 2.5% and grade III anemia in 1 (2.5%). 67.5% patients did not show any toxicity. Conclusion: All our patients were immunocompetent and with good performance status (ECOG). The prognosis of patients with high dose methotrexate based chemotherapy has improved during the last decades and appears safe. This analysis is still ongoing. Publication History Article published online: 20 February 2026 © 2026. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/) Thieme Medical and Scientific Publishers Pvt. Ltd. A-12, 2nd Floor, Sector 2, Noida-201301 UP, India
Author: Punam Rabha
Institution: Fortis Memorial Research Institute
Language: English
Subfield: Clinical Neurology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7130717874